Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection

Fitzner, Julia; Qasmieh, Saba; Mounts, Anthony W.; Alexander, Burmaa; Besselaar, Terry G.; Briand, Sylvie; Brown, Caroline; Clark, Seth; Dueger, Erica; Gross, Diane; Hauge, Siri Helene; Hirve, Siddhivinayak; Jorgensen, Pernille; Katz, Mark A.; Mafi, Ali; Malik, Mamunur Rahman; McCarron, Margaret; Meerhoff, T J; Mori, Yuichiro; Mott, Joshua A.; Olivera, Maria Teresa da Costa; Ortiz, Justin R.; Palekar, Rakhee; Rebelo-de-Andrade, Helena; Soetens, Loes; Yahaya, Ali Ahmed; Zhang, Wenqing; Vandemaele, Katelijn

doi:10.2471/blt.17.194514

Cited by 241 publications

(246 citation statements)

References 24 publications

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“…Likewise, it was not a significant predictor of confirmed influenza in all age groups in the United States study by Shah et al [12] in 2009-2011, which found that the most discriminating clinical manifestations, with an aDOR >3, were cough and fever. Our results support the removal of sore throat from the clinical case definition in order to improve performance, as suggested by other authors [5].…”

Section: Discussionsupporting

confidence: 92%

“…In our opinion, the impact of this limitation may be minimal, as other factors, such as individual and daily variations, the site of measurement, and the natural trend for physicians to round temperatures up or down, can influence the measured temperature [9]. Secondly, age, the influenza type and subtype [5], or the season [18] might be partially responsible for differences in the performance of the variables studied. However, we adjusted for age and season, and it seems improbable that our results are invalid.…”

Section: Discussionmentioning

confidence: 94%

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Usefulness of Clinical Definitions of Influenza for Public Health Surveillance Purposes

Domı́nguez

Soldevila

Torner

et al. 2020

Viruses

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This study investigated the performance of various case definitions and influenza symptoms in a primary healthcare sentinel surveillance system. A retrospective study of the clinical and epidemiological characteristics of the cases reported by a primary healthcare sentinel surveillance network for eleven years in Catalonia was conducted. Crude and adjusted diagnostic odds ratios (aDORs) and 95% confidence intervals (CIs) of the case definitions and symptoms for all weeks and epidemic weeks were estimated. The most predictive case definition for laboratory-confirmed influenza was the World Health Organization (WHO) case definition for ILI in all weeks (aDOR 2.69; 95% CI 2.42-2.99) and epidemic weeks (aDOR 2.20; 95% CI 1.90-2.54). The symptoms that were significant positive predictors for confirmed influenza were fever, cough, myalgia, headache, malaise, and sudden onset. Fever had the highest aDOR in all weeks (4.03; 95% CI 3.38-4.80) and epidemic weeks (2.78; 95% CI 2.21-3.50). All of the case definitions assessed performed better in patients with comorbidities than in those without. The performance of symptoms varied by age groups, with fever being of high value in older people, and cough being of high value in children. In patients with comorbidities, the performance of fever was the highest (aDOR 5.45; 95% CI 3.43-8.66). No differences in the performance of the case definition or symptoms in influenza cases according to virus type were found.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 94%

Usefulness of Clinical Definitions of Influenza for Public Health Surveillance Purposes

Domı́nguez

Soldevila

Torner

et al. 2020

Viruses

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“…This finding is in keeping with surveillance definitions for influenza-like illness, which limit cough duration to 7-10 days. 37,38 Patients with respiratory viral infection were as likely as other patients to receive chest X-rays and to have abnormalities on chest X-ray. However, more than 50% of patients who had respiratory virus identified were treated with antibiotics at enrollment.…”

Section: Discussionmentioning

confidence: 99%

Respiratory Viral Infection: An Underappreciated Cause of Acute Febrile Illness Admissions in Southern Sri Lanka

Tillekeratne

Bodinayake

Simmons³

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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The contribution of respiratory viruses to acute febrile illness (AFI) burden is poorly characterized. We describe the prevalence, seasonality, and clinical features of respiratory viral infection among AFI admissions in Sri Lanka. We enrolled AFI patients ³ 1 year of age admitted to a tertiary care hospital in southern Sri Lanka, June 2012-October 2014. We collected epidemiologic/clinical data and a nasal or nasopharyngeal sample that was tested using polymerase chain reaction (Luminex NxTAG, Austin, TX). We determined associations between weather data and respiratory viral activity using the Spearman correlation and assessed respiratory virus seasonality using a Program for Appropriate Technology definition. Bivariable and multivariable regression analyses were conducted to identify features associated with respiratory virus detection. Among 964 patients, median age was 26.2 years (interquartile range 14.6-39.9) and 646 (67.0%) were male. One-fifth (203, 21.1%) had respiratory virus detected: 13.9% influenza, 1.4% human enterovirus/ rhinovirus, 1.4% parainfluenza virus, 1.1% respiratory syncytial virus, and 1.1% human metapneumovirus. Patients with respiratory virus identified were younger (median 9.8 versus 27.7 years, P < 0.001) and more likely to have respiratory signs and symptoms. Influenza A and respiratory viral activity peaked in February-June each year. Maximum daily temperature was associated with influenza and respiratory viral activity (P = 0.03 each). Patients with respiratory virus were as likely as others to be prescribed antibiotics (55.2% versus 52.6%, P = 0.51), and none reported prior influenza vaccination. Respiratory viral infection was a common cause of AFI. Improved access to vaccines and respiratory diagnostics may help reduce disease burden and inappropriate antibiotic use.

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“… (A) Distribution of self-reported influenza-like illness cases according to the WHO definition 41 over the 10 selected urban quarters. The number of Influenza-like illness cases per incoming answers is expressed as percentage value for each quarter.…”

Section: Resultsmentioning

confidence: 99%

High-resolution influenza mapping of a city reveals socioeconomic determinants of transmission within and between urban quarters

Egli

Goldman

Müller

et al. 2020

Preprint

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162/150) 39 40With two-thirds of the global population projected to be living in urban areas by 2050, 41 understanding the transmission patterns of viral pathogens within cities is crucial for effective 42 prevention strategies. Here, in unprecedented spatial resolution, we analysed the socioeconomic 43 determinants of influenza transmission in a European city. We combined geographical and 44 epidemiological data with whole genome sequencing of influenza viruses at the scale of urban 45 quarters and statistical blocks, the smallest geographic subdivisions within a city. We observed 46 annually re-occurring geographic clusters of influenza incidences, mainly associated with net Introduction: 54Transmission of influenza is influenced by extensive but poorly understood interactions between 55 various viral, host and environmental factors 1-3 . Influenza may serve as a model for pandemic 56 threats including the most recent COVID-19 pandemic. Whole viral genome sequencing has 57 enabled reconstruction of phylogenetic relatedness at high resolution. Using these approaches, 58the interactions and dynamics of influenza transmission events have been described across a 59 range of scales: globally 4-6 , across continents 1,7 , in university campuses 8 , or within households 9-60 12 . With two-thirds of the global population projected to be living in urban areas by 2050, 61 understanding the transmission patterns of influenza within cities is crucial for effective prevention 62 strategies and may help to prepare for pandemic threats. Previous work identified cities as 63 containing critical chains of transmission outside of peak climatic conditions (Dalziel, B. D. et al 64 Science 2019), but the resolution to look at these critical intra-city transmission chains in detail 65 has until now been lacking. Very few studies have explored transmission events and dynamics of 66 influenza viruses at the scale of a city 13-17 . Cities are heterogeneous with remarkably different 67 neighbourhoods based on the socioeconomic position of the individuals living there. 68Consequently, a high spatial resolution of the urban space and built environment is crucial to fully 69 understanding the impact of factors linked to health and disease 18,19 . 71In this study we combine epidemiologic, geographical and demographical factors at the 72 unprecedented resolution of urban quarters (i.e. neighbourhood/area) and statistical blocks (i.e. 73city block/street) levels, the smallest statistical enumeration areas within a city. Basel, 74Switzerland, serving as our model city, we explored the local patterns of influenza distribution and 75 transmission from 2013 to 2018. Basel has urban quarters that differ substantially in 76 socioeconomic indicators and housing structure. By using information at the level of statistical 77 blocks, we were able to construct a detailed picture of influenza transmission within the city. We 78 visualized kernel density estimates of influenza cases (reflecting the clustering of cases), a 79 fundamental data smoothing me...

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Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection

Cited by 241 publications

References 24 publications

Usefulness of Clinical Definitions of Influenza for Public Health Surveillance Purposes

Usefulness of Clinical Definitions of Influenza for Public Health Surveillance Purposes

Respiratory Viral Infection: An Underappreciated Cause of Acute Febrile Illness Admissions in Southern Sri Lanka

High-resolution influenza mapping of a city reveals socioeconomic determinants of transmission within and between urban quarters

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